Phase II study of concurrent chemoradiotherapy with high-dose-rate intracavitary brachytherapy in patients with locally advanced uterine cervical cancer: efficacy and toxicity of a low cumulative radiation dose schedule.

Abstract

OBJECTIVE:

A multicenter phase II trial was conducted to assess the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with high-dose-rate intracavitary brachytherapy (HDR-ICBT) using a low cumulative prescribed dose schedule in patients with locally advanced uterine cervical cancer.

METHODS:

The Japanese Gynecologic Oncology Group (JGOG) study JGOG1066 enrolled patients with FIGO stages III-IVA uterine cervical cancer who had no para-aortic lymphadenopathy (>10 mm) assessed by CT. Patients received definitive radiotherapy (RT) consisting of external beam whole pelvic RT and HDR-ICBT. The cumulative linear quadratic equivalent dose (EQD2) was 62-65 Gy prescribed at point A. Cisplatin 40 mg/m(2) weekly was administered concurrently with RT for 5 courses.

RESULTS:

Of the 72 patients registered, 71 were eligible. With a median follow-up of 28 months, the 2-year progression-free survival rate and pelvic disease progression-free rate were 66% (95% CI, 54% to 76%) and 73% (95% CI, 61% to 82%), respectively. Progression-free survival decreased significantly with increased central tumor size (P=0.036). The 2-year cumulative late complication rates were 24% for all grades, 9% for grade 1, 12% for grade 2, 3% for grade 3, and 0 for grades 4/5.

CONCLUSIONS:

The JGOG1066 demonstrated that CCRT using HDR-ICBT with a low cumulative RT dose schedule achieved comparable outcome as those achieved with global dose schedules (EQD2=85 Gy) with a lower incidence of late toxicity for locally advanced uterine cervical cancer in a Japanese population.

• Authors: Takafumi Toita, Ryo Kitagawa, Tetsutaro Hamano, Kenji Umayahara, Yasuyuki Hirashima, Yoichi Aoki, Masahiko Oguchi, Mikio Mikami, Ken Takizawa, Cervical Cancer (Vulva Cancer) Committee of Japanese Gynecologic Oncology Group (JGOG)
• Journal: Gynecologic oncology (Gynecol Oncol) Vol. 126 Issue 2 Pg. 211-6 (Aug 2012) ISSN: 1095-6859 [Electronic] United States
• PMID: 22555110 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Antineoplastic Agents
• Cisplatin

Topics

• Adult
• Aged
• Antineoplastic Agents (administration & dosage, adverse effects)
• Brachytherapy (adverse effects, methods)
• Chemoradiotherapy (adverse effects, methods)
• Cisplatin (administration & dosage, adverse effects)
• Disease-Free Survival
• Dose Fractionation, Radiation
• Drug Administration Schedule
• Female
• Humans
• Middle Aged
• Prospective Studies
• Radiotherapy Dosage
• Treatment Outcome
• Uterine Cervical Neoplasms (drug therapy, pathology, radiotherapy)